Effects of quinapril on clinical outcome after coronary artery bypass grafting (the QUO VADIS study)

Oosterga, M; Voors, Adriaan A.; Pinto, Yigal M.; Buikema, Hendrik; Grandjean, Jan G.; Kingma, J. H.; Crijns, Harry J.G.M.; Gilst, Wiek H. van

doi:10.1016/s0002-9149(00)01428-4

Cited by 127 publications

(66 citation statements)

References 14 publications

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“…In the overall QUO VADIS population, beneficial effects of quinapril on cardiovascular events were demonstrated. 7 On the basis of the findings in the present study, one might assume that the beneficial effects of quinapril might be restricted to DD-patients only. …”

Section: Papermentioning

confidence: 64%

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Vascular effects of quinapril completely depend on ACE insertion/deletion polymorphism

Voors

Geel

Oosterga

et al. 2004

J Renin Angiotensin Aldosterone Syst

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IntroductionThe angiotensin-converting enzyme (ACE) DDgenotype is associated with increased plasma and myocardial ACE-activity. The influence of the ACE insertion/deletion (I/D) polymorphism on the effects of ACE-inhibition on vascular responses has not been previously described. Materials and methodsIn the randomised, double-blind QUinapril On Vascular ACE and Determinants of Ischemia Study (QUO VADIS), 149 patients undergoing coronary bypass surgery were randomised to receive either the ACE inhibitor, quinapril, or placebo. In 82 patients, we obtained ACE-genotype, and measured vascular responses to angiotensin II (Ang II) in left internal mammary arteries. Conclusions DD-genotype patients showed decreased vascular responses to Ang II but treatment with quinapril completely restored the decreased vascular response in DD-genotype patients to the same level as II/IDgenotype patients, while no effect of quinapril was demonstrated in the II/ID-genotype patients. Results In IntroductionThe insertion/deletion (I/D) polymorphism of a 287-bp Alu element in intron 16 of the angiotensin-converting enzyme (ACE) gene has been consistently related to serum ACE-activity. Patients with the DD-genotype have higher serum ACE-activity levels compared with ID-and IIpatients.

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Section: Papermentioning

confidence: 64%

“…The results of this study are presented elsewhere. 6,7 A total number of 149 patients were randomised to quinapril (40 mg/day) or placebo. Treatment was started at least two weeks before coronary bypass surgery, and continued for one year after surgery.…”

Section: Patient Selection and Treatmentmentioning

confidence: 99%

Vascular effects of quinapril completely depend on ACE insertion/deletion polymorphism

Voors

Geel

Oosterga

et al. 2004

J Renin Angiotensin Aldosterone Syst

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“…The QUO VADIS (Quinapril on Clinical Outcome After Coronary Artery Bypass Grafting) study of 149 patients documented a reduction in the composite outcome of angina, death, myocardial infarction, repeat revascularization, stroke, or transient ischemic attacks in patients who received quinapril for 1 year after CABG compared with placebo (3.5% versus 15%, quinapril versus placebo, Pϭ0.02). 27 However, these findings were not confirmed in the larger multicenter IMAGINE (Ischemia Management with Accupril post bypass Graft via Inhibition of angiotensin coNverting Enzyme) trial of 2204 patients, which showed quinapril to have no benefit compared with placebo when administered after CABG. 28, 29 The present results should be interpreted in the context of several limitations.…”

Section: Kulik Et Al Statins and Outcomes After Cabgmentioning

confidence: 96%

Impact of Statin Use on Outcomes After Coronary Artery Bypass Graft Surgery

et al. 2008

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Background-The benefits of statins have been demonstrated for patients with a remote history of coronary artery bypass grafting (CABG); however, no investigation to date has evaluated whether initiation of statin therapy in the early months after surgery improves clinical outcomes. Methods and Results-A retrospective cohort of 7503 Medicare patients Ն65 years of age who underwent CABG (1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003) was assembled by use of linked hospital and pharmacy claims data. Rates of all-cause mortality and major adverse cardiovascular events were compared between patients who were (nϭ1745) and were not (nϭ5788) prescribed statins within 1 month of CABG discharge. Additional analyses evaluated the impact of statin initiation between 1 and 6 months after surgery. Multivariable and propensity score analysis demonstrated that statin use within 1 month of CABG discharge independently reduced the risk of all-cause mortality (adjusted hazard ratio 0.82, 95% confidence interval 0.72 to 0.94) compared with no statin use. Similarly, statin use within 1 month of CABG discharge independently reduced the risk of major adverse cardiovascular events (adjusted hazard ratio 0.89, 95% confidence interval 0.81 to 0.98). Initiation of statin therapy between 1 and 6 months after CABG discharge was also associated with reductions in major adverse cardiovascular events and mortality; however, outcome rates between early (Յ1 month after CABG) and delayed (1 to 6 months after CABG) statin initiation were not significantly different. Conclusions-Statin therapy initiated in the early months after hospital discharge independently reduces all-cause mortality and major adverse cardiovascular events after CABG. These findings validate the widespread practice of prescribing long-term statin therapy after CABG. (Circulation. 2008;118:1785-1792.)

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“…1- 4 In the Effects of Quinapril on Vascular Angiotensin-Converting Enzyme and Determinants of Ischemia trial, patients were randomized 4 weeks before CABG to receive either quinapril (40 mg/day) or placebo for 1 year after surgery. 1 Patients treated with quinapril had a 77% reduction in ischemic events (death, revascularization, myocardial infarction, recurrence of angina pectoris, ischemic stroke, or transient ischemic attack stroke; 15% vs 4%; P=0.04). Quinapril was well tolerated and was not associated with any untoward perioperative hemodynamic events.…”

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confidence: 92%

Role of Renin-Angiotensin System Inhibitors in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting

Kinoshita

Asai

2010

Circ J

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Effects of quinapril on clinical outcome after coronary artery bypass grafting (the QUO VADIS study)

Cited by 127 publications

References 14 publications

Vascular effects of quinapril completely depend on ACE insertion/deletion polymorphism

Vascular effects of quinapril completely depend on ACE insertion/deletion polymorphism

Impact of Statin Use on Outcomes After Coronary Artery Bypass Graft Surgery

Role of Renin-Angiotensin System Inhibitors in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting

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